Friday, February 15, 2013

Mornings are the best, but by the time noon rolls around, I am wiped out. My leg either hurts me or is extremely uncomfortable. I am quite helpless. I cannot stand or walk on my own and must use a walker. This means I cannot carry a damn thing. We considered putting a basket on my walker but that did not work because my walker does not fit through the doors to any of the bathrooms unless I go sideways and even then it is a "just fit" with no room for a basket on the walker!!

In the kitchen I can manage a little bit -- I can get food from the cabinets or fridge and place them on the counter which is close. I can even prepare some food. I can slide my prepared food over to the part of counter close to the table and I can sit down, reach over the get the food and sit down and eat. But I cannot carry anything over to my "office" -- which has now been moved to a corner of my living room as I cannot get down the stairs to where it normally is.

I can do stairs, albeit with humongous difficulty but there must be at least one railing for me to hold onto. There are NO railings on the half flight of steps at the end of the hall which leads to my office. The only way in and out of my home is to go down or up a flight of stone steps. There is a railing, but only one one side of the very wide staircase. I use the railing with a crutch to make my way up or down. Up is excruciatingly difficult. Down is less so.

I have exercises I am supposed to do daily. I finally got smart and started doing them first thing in the morning rather than heading straight for my corner with the computer and cup of coffee. So, now that I am doing them I hope it will help to strengthen the leg so I can start putting more and more weight on it and less on my hands, arms, and pectoral muscles. Speaking of my pectoral muscles -- they HURT -- from using them! It makes moving around ever that much more difficult. OY!

I am taking drugs aplenty. Targin, Optalgin, Percocet, Cephalex, Vitamins C, D and Calcium, a drug to prevent blood clots (injected into my abdomen daily), Xanax (prescribed as a muscle relaxant when the calf muscles of my right leg were cramping -- but Xanax is also helpful at reducing my anxiety a bit and helping me sleep, nice side effects). I am taking Arnica (sublingually) to help my bone and muscle tissue to heal, eating a banana a day for the cramping.

I do not have much of an appetite, but I eat. Yogurt and granola for breakfast, soup or pasta for lunch, or maybe a sandwich. Dinner is whatever my daughter decides to make. Could be chicken, or meat, or soup or something. I miss cooking.

I am keeping my leg elevated much of the time but I alternate and sometimes sit normally with my leg down. My PT told me I should vary my position a lot and I should get up and walk a bit. Hard to do with the upper muscles in pain!

Everything I do takes SO MUCH longer to do. I have to plan ahead because if I forget something it means another long painful walk to get it (esp if no on else is home or if my daughter is pre-occupied with caring for the kids). I was recently invited to spend a Shabbat at the home of a friend who is getting married, for her Shabbat Kallah. The plan was to make the "party" time of the Shabbat Kallah at her neighbor's house. I told them that I cannot do that kind of walk and their response was, "it is only one house over". They have NO IDEA that "only one house over" FEELS like a hundred houses over for me. It is too much for me yet. The plan was changed, however, when they learned that the forecast is for rain. Now it will take place in my friends home where I will be anyway.

Taking a shower. Now there's an experience! The shower in my private bathroom is a small stall with a very narrow aperture through which to access it. So, I cannot use that. That means I have to use the shower/tub in the main bathroom. As I mentioned above. access to the bathroom is sideways, the only way I and my walker will fit through the door. Once in, I shut the door and then: I place a large towel on the floor. Then there is a folding chair I open on top of that, and I place the chair so it is facing the tub, up against the side wall of the tub. (Bear in mind, I am doing this standing on one good leg and one bad leg with my walker next to me in case i need to grab it.) I get undressed (I actually get undressed in my bedroom, and I have to remove all the surgical dressings from the pin sites before I shower, I put on a bathrobe and hobble out to the bathroom.) I drape my bathrobe over the walker (where I have two towels waiting for me there as well). I sit on the folding chair, and then very carefully lift up my legs and bring them down over the tub wall and into the tub. Then I shift my body forward until I am sitting on the tub edge. The folding chair remains in place behind my butt. I turn on the water and using the hose and shower attachment I get myself wet and then soapy and then rinse and then shampoo my hair and rinse that. Then, I carefully go back onto the folding chair and move my legs out of the tub. I cannot use a shower chair in the tub -- it is too narrow for any tub chair to fit. (no matter which way we face it). I cannot use a tub bench -- the tub edge next to the wall is far too narrow for that to be secure. I do not OWN the place so I cannot invest in adding accessible fixtures to the tub. So, this is what I am stuck with. It works. I get clean. It is just a bit more work than ideal.

I am back to work already, which has its good points and bad. Good in that it forces me up and about and out of the house and up and down those stairs. Bad for the same reasons and it both tires and stresses me out. No choice for me really, as I need the moolah, even if it is really a pittance. I get home about 2 PM from work and I am exhausted. I eat lunch and then I either take a cat nap or a shower, depending on the day and how I feel and what else is planned. If the PT or OT is coming that is a consideration.

I have at times been so exhausted that all I could do is cry - not the tears of emotional overwroughtness, but tears that stem from a physical organic source that I cannot stop even if I wanted to. Similar to the post partum tears I shed after I gave birth to my daughter Chloe. But there IS some emotional fallout for me. I am so independent and am trying to be so strong, wanting to be strong and not to fall apart -- it is at times overwhelming for me to feel this way. It is a new way of being for me and I am NOT used to it. My surgeon tells me, he is glad I am so independent. He likes that I am being so strong. And, I want to tell him, "but I am not. I am weak. I am feeling totally dependent." And I want to cry about that -- that I may not be living up to his perception of me as a strong person, someone who is so independent. Because I do not feel strong. I do not feel independent at this moment.

This is my life -- for now. I know it is temporary. I know it will change -- for the better. I know I have to go through this. And I am blessed -- I was given the opportunity to do this, to have this surgery, and in the process I am learning so much more about myself and what I can tolerate and what I can do, and what I cannot do. The hardest part for me is to forgive myself when I feel I am being weak and scared and stupid. It is hard to allow myself that.

Tuesday, February 5, 2013

On January 29th I entered Hadassah Ein Kerem
hospital for a major surgical procedure to correct a deformity in my right
leg. You may read my previous posts for
more information about that deformity and about my travails dealing with the
medical system here in Israel where I now live.

I went to the hospital by taxi,(costing me a pretty penny),
armed with a walker, all my medical records, a few changes of clothing and
underwear, some toiletries, my cell phone, and eReader. And of course, a certain amount of confidence
mixed with trepidation.

I went alone as I was unable to arrange for a family member
to accompany me. This is Israel and life
in Israel can be rather inconvenient under the best of circumstances, and this
was not one of those times. However, I
was able to arrange for a very good friend to be there for me when I came out
from under. I chose her not only because
she is a good and dear friend and because I trusted her implicitly, but also because
it so happens that by avocation she is a health information management expert,
and by experience she has intimate knowledge of the Israeli medical
establishment and system. It also did
not hurt that she speaks Hebrew fluently.
I have a pretty good grasp of conversational Hebrew, and she would later
write in an update to my friends and family that “her Hebrew is good enough for
her needs”. As promised she was there
when I came around.

After I arrived at the hospital and went to the Orthopedics
ward I was checked in and assigned a room.
I was shown where to put my things – there was a safe in the room with
an electronic keypad with which I was to create my own passcode. Unfortunately, the safe’s locking mechanism
was broken and I was unable to lock it up.
I thus refused to leave the room until it was either fixed, or I was moved
to a room with a working safe, or some other viable alternative was offered to
me for the security of my cellphone, eReader, and cash/credit cards. I left my jewelry at home. The aides came with the gurney to take me to
the OR, but I refused to go. They kept
telling me “but they are waiting for you in the OR”. I would not move, and said, not until my
belongings are secure. One of the nurses
suggested I leave the stuff in a bag at the nurse’s station. I asked if she would take responsibility for
my things to which she replied, “no way!”.
Again I refused to move. Finally,
they brought in security. After a failed
attempt to fix the safe’s locking mechanism, they used a key to open and then
lock it. But they would not give me the
key (it is a master). But, they agreed
to take responsibility for my things.
And so, I agreed and then was on my way.

Interestingly enough, I was still pretty calm and not so
scared at this point. Last month, when I
had been originally scheduled for the surgery, I had been far more
nervous. (Read previous post to learn
why that surgery was cancelled at the last minute). I was brought to the prep room that is
directly before the OR. There, I was
prepped for the surgery. Connected to
IV. Last minute vitals read. Then the anesthesiologist arrived. We spoke
briefly and then I was brought into the OR and placed on what I can only
describe as a board. People refer to
this as the operating table but it was little more than a board.

Since I had elected to use regional
anesthesia, an epidural, I was first instructed to sit on the board, legs
hanging over, hands on my knees and then to lean over a bit while the lumbar
puncture was made.After successful insertion
of the catheter for the administration of the epidural, I was told to “sit up
straight” and then I began to feel an icy cold liquid begin to course through
me.

Before I move on, I want to remind my dear readers that I am
severely to profoundly hard of hearing and wear hearing aids. But for the surgery I’d been told to remove
my hearing aids and they were locked up in the safe. (At a cost of appx $8000
USD of course they would be locked up!) Without my hearing aids I am
functionally deaf. So all of the input I
was experiencing at this point was visual, or via my sense of touch, or smell. Taste was not on the menu here!

Shortly thereafter I was told to lie back on the board. By now I was shivering uncontrollably, teeth
chattering audibly. My arms were placed
on boards perpendicular to the one on which I now lay, and strapped down – a surgical
cross or crucifix, if you will. Then, I
began to feel slightly “woozy” which indicated to me the beginning of the
administration of a sedative, as per agreement I had with the anesthesiologist.
I had told him that I wanted to be as unaware as possible of what was going
on. I thought it would be too scary for
me otherwise. After that moment I
remember nothing of the surgery (although I discovered some vestigial memory,
about which I will write a bit later on).

My next memory is of coming around, becoming conscious, and
feeling weird, and some pain, and seeing a hustle and bustle of nurses and
doctors around me, and then seeing the smiling face of my good friend, Yocheved
Golani – the aforementioned good and dear friend who would be there for me when
I came out of surgery. As promised,
there she was. I vaguely recall checking
under my blankets to see my new body piercing. Here is what it looks like:

My memory of being in the recovery room is somewhat
vague. I do know that I was after a
while somewhat lucid, I vaguely recall my surgeon coming to check on me, and I
recall talking to Yocheved, and being shown my PCA –although perhaps that did
not happen until I was safely ensconced in my room. I will have Yocheved add to this to fill in
the gaps where my memory has lapsed. I
also do remember being told that the anesthesia stopped working at some point
but everyone was quick to tell me that it was already after the surgery had
been completed. But I fear I went
through some real trauma beyond what was expected in terms of pain that I was
feeling. That fear is fueled by some of
the “nightmares” I have had subsequently in which I seem to be in a dark, cold
place and I experience the feelings of my body being yanked and clamped and
invaded – and during which I experience a real full body “jerk” in my sleep
that wakens me.

As mentioned before, I was given PCA (Patient Controlled
Anesthesia) of morphine. I think it
helped me. It is hard for me to
know. I was still bedridden and
suffering the indignity of wearing a diaper.
Gosh those things are HUGE!
Initially I seemed to be unable to urinate—which I was told is a “side
effect” of the medication. I felt
enormous pressure on my bladder and it was overwhelmingly uncomfortable. I found that I had to “help myself along” by
using my hands to press down on my bladder.
(Is this TMI? If so, sorry – but I
feel that these are details that no one discusses and so the reality of what
one can expect to experience remains a secret.
The unknown can be very scary, at least for me. I prefer to know more rather than less.

Some of my memory in terms of the sequence of events is a
bit hazy. My friend went home early
Tuesday evening (at my urging as I knew if she stayed longer she would have a
harder time getting home – she was dependent on either public transportation,
or “tremping”, the Israeli term for hitchhiking). I think I slept well that night. In the morning I woke in pain but a few
presses of the “pain pump” helped me with that. I do not recall if it was on Wednesday or on
Thursday that I asked to be taken to the bathroom using the special wheelchair
with a hole in it that can be wheeled right over the toilet. I THINK I did that on Wednesday. I do remember
that when my surgeon came round to see me and I told him that I was using the
toilet and not a diaper he was quite surprised.
He had not expected that I would attempt being “up and about” so
quickly. It was not until the next day,
Thursday, that the physiotherapist came
around to see me and to begin his treatment with me. I remember I was terrified
of it. I had, at that point been taken
off the PCA and given a round of drugs which I could (and would) take. The main pain drug I was given is Targin
which has oxycodone and naloxone. I was
also given Optalgin (dipyrone- an analgesic).
I have limited my intake of this and I may substitute Tylenol for
this. The third drug for pain I am given
is Percocet. That has Tylenol in it and
more Oxycodone. I guess I have to be
careful of the amount of Tylenol I ingest.
I only take the Percocet “as needed”.
I have been limiting myself to taking it only once a day. I think I would deal better with the pain if
I took it once in the morning and one at night.
I might do that and stop the Optalgin altogether. Other meds I am taking are Clexane, an
injected drug once a day that is an anti-coagulant to prevent blood clots, and
vitamins D and C and Calcium, and Cefurax, an antibiotic. I have added the homeopathic Arnica to this.
Arnica is supposed to promote healing of muscle and bone tissue. I also must change the dressings on my pin
sites 2x a day.

Anyway I made sure to take Percocet about a half hour before
the physiotherapist was due to see me. I
figured, rightly, that it would make it easier for me to do the exercises which
he would surely give me. It was VERY
scary for me to take those first steps, albeit with a walker. I am not putting full weight on my leg, I
cannot do that, but partial weight. It
is scary and, without the Percocet, painful.
But I am doing it and putting myself through more exercise by taking “walks”. I would walk the length of the corridor and
back. It might take me a half hour or
more to do it and I would be EXHAUSTED at the end, but I feel that it is very
important for me to remain active.

On Wednesday morning, when my surgeon came to see me, he
told me, upon examining my leg in the frame that the rotation looks good, but
the angle may need some correction. On
Friday morning when he came I told him
that I agreed that the angle did not look right. He said he would fix it on Sunday morning. I said no, I wanted him to fix it right then
and there. He told me it would hurt a
bit and I smiled and said, I just took Percocet. Strike while the iron is hot. He went and got his wrench and made the
adjustments. It did not really HURT, it
just felt like a lot of pressure on my leg and was not comfortable. But I am glad I insisted on his making the
correction sooner rather than later. It
made it easier for me to straighten my leg at the knee – I would not be able to
have x-rays until I could do that satisfactorily and I would not be able to go
home until x-rays could be taken and they were satisfactory.

On Sunday morning I was taken to the X-ray dept. I was told
I would need to stand with my knees straight for the x-ray. No problem, or so I thought. Upon arrival I was asked to “please step up
onto this (little itty bitty) stool” for the x-ray…! Well, there was no way I could do that. I had not brought my walker or crutches with
me – I had not been told I would need them and there was nothing for me to grab
hold of, to put my weight on so I could LIFT myself into that position. Finally, the aides there were “helping” me
get up but they were so inept that I inadvertently wound up putting my FULL
WEIGHT on the broken leg! I SCREAMED,
and nearly passed out, but hyperventilated instead. Finally, though I was in the right place and
I stood there, stony faced and ANGRY.There was NO REASON I should have had to endure that.

I also asked to be brought to the offices of Yad Sarah. Yad Sarah is an organization in Israel that
helps to provide medical equipment and supplies to patients who need them. They actually do it for free, but one must
pay a nominal fee to borrow an item – a fee which is reimbursed to the patient
upon return of the borrowed items. I
needed crutches as I had thought only to procure a walker prior to the
surgery. I knew I would need the
crutches to learn how to navigate stairs.
An aide brought me down to the Yad Sarah office where I not only
arranged to borrow a pair of crutches, but I also arranged for purchase and
delivery of a showering chair. I could
not borrow one as they did not have the kind that would be good for my needs
and that would fit in my bathtub or shower!
It was not so expensive (about $63 USD) and when I no longer need it I
will likely donate it to a “gemach” here on the Yishuv in which I live (a
Gemach is similar to the Yad Sarah service but they do not always require a
deposit for borrowing. A Yishuv is a
village.).

Later that afternoon, my surgeon came by and told me that he
saw the x-rays and told me “they are PERFECT” and “you can go home tomorrow”. Of course, I was ecstatic about the return
home but still worried about the issue of the stairs. There is a double set of wide stone stairs
that leads (down) to my home. I still
had not learned how to manage them.

The next day, in the morning, the PT came by and I told him
he had to teach me to use the crutches and do stairs. He brought me to the PT room and began to
teach me. In the hospital the PT is
allotted only twenty minutes to spend with each patient. He stayed with me for a half hour. It was TERRIBLE. I absolutely could NOT manage the stairs. Believe me, I tried hard. So hard that I was
DRIPPING sweat, I was SOAKED with sweat.
In the end, I collapsed, crying.
I finally realized that I was going to have to ask for a couple of
friends to physically help me down the stairs to my home. My very good friend Moshe Fuld came. Upon arrival home I discovered that my memory
had been faulty and that there actually was a railing on the stairs, albeit on
only one side. Using one crutch and the
railing I was able to make it down. At the point where the staircase took a
turn, the railing disappeared. My friend
Moshe was my “railing”. I leaned on him for each step the rest of the way
(about 6 steps). It turned out not to be
as bad as I had feared. But I knew that
would not be able to manage the stairs inside my house – a half a flight down
to the laundry area, guest room, and more importantly, my office. I spoke to my son in law and just this
morning he moved my computer and phone upstairs to a corner of the salon. It is not ideal but it will suffice until
such time as I am able to manage the stairs.

And this is where I am at now…I am home. Figuring things out, best ways and means of accomplishing my daily tasks, managing my pain, etc.

"We are making or have made aliyah on HaShem's command. He trusts us to use our GOD-given intelligence and developing emuna (rollercoastering wavering and strengthening emuna included) to make our lives work. Examine and rearrange your priorities to fit with the goal HaShem has for
us: bitachon in Av HaRachamim. Take it one baby step at a time. Gradual growth is more likely to last than sudden changes too hard to bear all at once." -- Yocheved Golani